MEDICARE: KRISTINE FRANK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	125577	CA

General Provider Information

NPI Number	:	1881420255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE FRANK LCSW

Provider Business Mailing Address
First Line	:	80415 SEGOVIA VIEW WAY
Second Line	:
City	:	LA QUINTA
State	:	CA
Zip	:	92253-0907
Country	:	US
Telephone Number	:	914-330-9531
Fax Number	:

Provider Business Practice Location Address
First Line	:	44651 VILLAGE CT STE 129
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-3823
Country	:	US
Telephone Number	:	760-501-8044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2024
Last Update Date	:	09/11/2024

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